Forum: How to stop an epidemic? Support Connecticut bill on opiate abuse

By Dr. Jeffrey Shelton

Published
6:44 pm EDT, Tuesday, March 31, 2015

Connecticut is facing an epidemic. It has affected every community across our state. The number of deaths from this epidemic in Connecticut has increased over 75 percent in the past two years alone. It’s not Ebola. It’s not cancer. It’s opiate overdose.

I am a psychiatrist and have worked in community hospitals in Connecticut for my entire professional career. Most of my practice has been working with patients who struggle with addiction. I’ve watched this epidemic emerge and claim the lives of too many people. The most frustrating part is that each of these deaths is preventable because we have an antidote which is nearly universally effective. Naloxone, an opiate antagonist, has been in clinical use for decades. It is a safe medication that can be administered via injection or nasal spray. It works by removing heroin or other opiates from receptors in the brain which reverses the effects of an overdose. The effect is rapid and restores the victim’s consciousness and breathing — thereby saving their life.

Recently, there has been a movement to increase the availability of Naloxone in the community to help curb the tragic increase in death from opiate overdose. The evidence for use of Naloxone in community settings in incontrovertible so it has been my mission to make Naloxone essentially a street drug in the communities where I have worked. I have had some success. Since I started prescribing Naloxone, to my knowledge, 10 potentially fatal overdoses have been reversed by prescriptions that I have written — and I am only one doctor. However, the severity of this epidemic and reluctance by some providers to prescribe Naloxone has left an unmet need leading to an ongoing rise in death from opiate overdose.

The state legislature recently introduced a bill that would make a sizable impact in the fight against this epidemic. House Bill 6856 proposes several measures that will reduce diversion and abuse of prescribed opiates. I have worked with hundreds of patients who struggle with IV heroin addiction and nearly every single one started their addiction with prescribed opiates. The majority of patients take these drugs responsibly and doctors prescribe them to help relieve suffering from acute and chronic pain. However, that doesn’t change the reality that prescription medications are the most common drug of abuse in Connecticut and prescription opiates are the gateway to serious, life threatening opiate addiction including IV heroin use.

H.B. 6856 also increases the accessibility of Naloxone by allowing anyone to go to their local pharmacy and obtain this medication from their pharmacist. Improving access of Naloxone is our best hope to stop this epidemic. While I am a strong supporter that police personnel and paramedics should carry Naloxone, the reality is that the real first responders are the friends and family members of those who are struggling with addiction. Of the 10 overdoses that have been reversed by prescriptions that I have written, all have been by someone who is either in recovery from addiction or is still actively using drugs. These overdoses included a parent, a neighbor, a friend, and a child. The more access people have to this life-saving medication the better.

Help stop this epidemic. Contact your state representative and advocate they support H.B. 6856.

Jeffrey Shelton, M.D., is chairman of the Department of Psychiatry at Middlesex Hospital.